Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-p566r Total loading time: 0 Render date: 2024-03-29T11:53:23.568Z Has data issue: false hasContentIssue false

6 - Alcoholism, nicotine dependence, and drug abuse

from Part I - Health promotion

Published online by Cambridge University Press:  21 August 2009

Mary-Anne Enoch
Affiliation:
Laboratory of Neurogenetics, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
Get access

Summary

Case: Mrs A., a middle-aged, smartly dressed woman who prided herself on her homemaker skills, came to see her family practitioner, Dr B., complaining of tiredness, depressed mood, anxiety, disturbed sleep, and weight gain. Dr B. knew that her husband, a well-known local politician, had recently left her for a younger woman, so he tactfully avoided that subject, asking instead after her grown children who lived out of state. After questioning Mrs A. about her symptoms, Dr B. concluded that she might be hypothyroid, depressed, anemic, or all three, and ran the appropriate tests. Several visits later, after normal test results and a failed trial of antidepressants, Dr B. was feeling baffled until Mrs A. finally broke down in tears and revealed the cause of her symptoms. She had been a heavy drinker in her youth but had managed to stop when she had decided to have children. However, the recent stress and humiliation of her husband's desertion and subsequent loss of self-esteem, social status, and role in life had been too much for her and she had taken to comforting herself during her long and empty days at home by drinking. Although she made great efforts to hide her drinking problem, she had now reached the point where she could no longer control her urge to drink and was frightened and desperate for help but feared the social stigma of being labeled an alcoholic.

Introduction

Mid life is a vulnerable time for women, both for the development of problem drinking and alcoholism and for the manifestation of the medical consequences of long-term addiction to alcohol and tobacco.

Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
, pp. 81 - 96
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alcoholics Anonymous: www.alcoholics-anonymous.org
Find local groups in telephone directory under “Alcoholism” or call 212 870 3400 (USA), 0845 769 7555 (UK)
Women for Sobriety: www.womenforsobriety.org
Tel. 1 800 333 1606 (USA)
Center for Substance Abuse Treatment: Tel. 1 800 662 HELP (USA) for information about local US treatment programs
National Institute on Alcohol Abuse and Alcoholism: www.niaaa.nih.gov
Public Information Office 301 443 3860 (USA)
National Clearinghouse for Alcohol and Drug Information: www.health.org
Tel. 1 800 729 6686 (USA)
Institute of Alcohol Studies (UK): www.ias.org.uk
Tel. 020 7222 4001 (UK)
Al-Anon (for spouses/partners) and Alateen (for children of alcoholics):
www.al-anon.alateen.org
Tel. 1 800 344 2666 (USA)
Kessler, R. C., McGonagle, K. A., Zhao, S., et al.Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch. Gen. Psychiatry 1994; 51:8–19CrossRefGoogle ScholarPubMed
Enoch, M.-A. and Goldman, D.Problem drinking and alcoholism: diagnosis and treatment. Am. Fam. Physician. 2002; 65:441–8, 449–50Google ScholarPubMed
Fleming, M. F.Strategies to increase alcohol screening in health care settings. Alcohol Health Res. World 1997.; 21:340–47Google ScholarPubMed
Kessler, R. C., Crum, R. M., Warner, L. A., et al.Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Arch. Gen. Psychiatry 1997.; 54:313–21CrossRefGoogle ScholarPubMed
Graham, K. and Wilsnack, S. C.The relationship between alcohol problems and use of tranquilizing drugs: longitudinal patterns among American women. Addict. Behav. 2000; 25:13–28CrossRefGoogle ScholarPubMed
Brown, G. L., Kline, W. J., Goyer, P. F., et al. Relationship of childhood characteristics to cerebrospinal fluid 5-HIAA in aggressive adults. In C. Chagass (ed.). Biological Psychiatry. New York: Elsevier; 1985. p. 177
Perkins, K. A.Sex differences in nicotine versus non-nicotine reinforcement as determinants of tobacco smoking. Exp. Clin. Psychopharmacol. 1996; 11:199–212Google Scholar
National Institute on Alcohol Abuse and Alcoholism. Alcohol and tobacco. Alcohol Alert 1998; 39:1–4
Enoch, M. A. and Goldman, D. Genetics of alcoholism and substance abuse. Psychiatr. Clin. North Am. 1999; 22:289–99
Heath, A. C., Bucholz, K. K., Madden, P. A. F., et al.Genetic and environmental contributions to alcohol dependence risk in a national twin sample: consistency of findings in women and men. Psychol. Med. 1997; 27:1381–96CrossRefGoogle Scholar
Enoch, M.-A., Harris, C. R. and Goldman, D. Sex differences in the role of anxious temperament in alcoholism and mood disorders. Fam. Med., submitted
Madden, P. A., Bucholz, K. K., Dinwiddie, S. H., et al.Nicotine withdrawal in women. Addiction 1997; 92:889–902CrossRefGoogle ScholarPubMed
Schuckit, M. A., Smith, T. L., Kalmijn, J., et al.Response to alcohol in daughters of alcoholics: a pilot study and a comparison with sons of alcoholics. Alcohol Alcohol. 2000; 35:242–8CrossRefGoogle Scholar
Heath, A. C.Genetic influences on alcoholism risk. A review on adoption and twin studies. Alcohol Health Res. World 1995; 19:166–71Google Scholar
Kendler, K. S., Heath, A. C., Neale, M. C., Kessler, R. C. and Eaves, L. J.A population-based twin study of alcoholism in women. J. Am. Med. Assoc. 1992; 268:1877–82CrossRefGoogle ScholarPubMed
Kendler, K. S., Neale, M. C., Heath, A. C., Kessler, R. C. and Eaves, L.A twin-family study of alcoholism in women. Am. J. Psychiatry 1994.; 151:707–15Google ScholarPubMed
Prescott, C. A., Aggen, S. H. and Kendler, K. S.Sex differences in the source of genetic liability to alcohol abuse and dependence in a population-based sample of U.S. twins. Alcohol Clin. Exp. Res. 1999; 23:1136–44CrossRefGoogle Scholar
Prescott, C. A. and Kendler, K. S.Genetic and environmental contributions to alcohol abuse and dependence in a population-based sample of male twins. Am. J. Psychiatry 1999.; 156:34–40CrossRefGoogle Scholar
Hettema, J. M., Corey, L. A. and Kendler, K. S.A multivariate genetic analysis of the use of tobacco, alcohol and caffeine in a population-based sample of male and female twins. Drug Alcohol Depend. 1999; 57:69–78CrossRefGoogle Scholar
Goldman, D. and Bergen, A.General and specific inheritance of substance abuse and alcoholism. Arch. Gen. Psychiatry 1998.; 55:964–5CrossRefGoogle ScholarPubMed
Kendler, K. S., Walters, E. E. and Neale, M. C.The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Arch. Gen. Psychiatry 1995.; 52:374–83CrossRefGoogle ScholarPubMed
Lex, B. W.Gender differences and substance abuse. Adv. Subst. Abuse 1991.; 4:225–96Google Scholar
Wilsnack, S. C., Wilsnack, R. W. and Hiller-Sturmhofel, S.How women drink: epidemiology of women's drinking and problem drinking. Alcohol Health Res. World 1994.; 18:173–80Google Scholar
Wilsnack, S. C. and Wilsnack, R. W.Drinking and problem drinking in US women. Patterns and recent trends. Recent Dev. Alcohol. 1995; 12:29–60Google ScholarPubMed
Vogeltanz, N. D., Wilsnack, S. C. and Harris, T. R.Prevalence and risk factors for childhood sexual abuse in women: national survey findings. Child Abuse Negl. 1999; 23:579–92CrossRefGoogle ScholarPubMed
Winfield, I., George, L. K., Swartz, M.et al.Sexual assault and psychiatric disorders among a community sample of women. Am. J. Psychiatry 1990.; 147:335–41Google Scholar
Wilsnack, S. C., Vogeltanz, N. D., Klassen, A. D. and Harris, T. R.Childhood sexual abuse and women's substance abuse: national survey findings. J. Stud. Alcohol 1997.; 58:264–71CrossRefGoogle ScholarPubMed
Winfield, I., George, L. K., Swartz, M. and Blazer, D. G.National Institute on Drug Abuse. Capsules. Women and Drug Abuse 1994.; 6:2Google Scholar
Gomberg, E. S.Risk factors for drinking over a woman's lifespan. Alcohol Health Res. World 1994; 18:220–27Google Scholar
Caetano, R.Drinking and alcohol-related problems among minority women. Alcohol Health Res. World 1994.; 18:233–41Google Scholar
Rosenberg, L., Palmer, J. R., Rao, R. S. and Adams-Campbell, L. L.Patterns and correlates of alcohol consumption among African-American women. Ethn. Dis. 2002; 12:548–54Google ScholarPubMed
Holman, C. D., English, D. R., Milne, E. and Winter, M. G.Meta-analysis of alcohol and all-cause mortality: a validation of NHMRC recommendations. Med. J. Aust. 1996; 164:141–5Google ScholarPubMed
Day, C. P.Who gets alcoholic liver disease: nature or nuture?J. R. Coll. Physicians Lond. 2000; 34:557–62Google ScholarPubMed
Wuethrich, B.Does alcohol damage female brains more?Science 2001.; 291:2077–9CrossRefGoogle ScholarPubMed
Smith-Warner, S. A., Spiegelman, D., Yuan, S. S., et al.Alcohol and breast cancer in women: a pooled analysis of cohort studies. J. Am. Med. Assoc. 1998; 279:535–40CrossRefGoogle ScholarPubMed
Hamajima, N., Hirose, K., Tajima, K., et al.Alcohol, tobacco and breast cancer – collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br. J. Cancer 2002.; 87:1234–45Google ScholarPubMed
Chen, W. Y., Colditz, G. A., Rosner, B., et al.Use of postmenopausal hormones, alcohol, and risk for invasive breat cancer. Ann. Intern. Med. 2002; 137:798–804CrossRefGoogle Scholar
Thun, M. J., Peto, R., Lopez, A. D., et al.Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N. Engl. J. Med. 1997; 337:1705–14CrossRefGoogle ScholarPubMed
Beckman, L. J.Treatment needs of women with alcohol problems. Alcohol Health Res. World 1994.; 18:206–11Google Scholar
Smith, W. B. and Weisner, C.Women and alcohol problems: a critical analysis of the literature and unanswered questions. Alcohol. Clin. Exp. Res. 2000; 24:1320–21CrossRefGoogle ScholarPubMed
Dahlgren, L. and Willander, A.Are special treatment facilities for female alcoholics needed? A controlled 2-year follow-up study from a specialized female unit (EWA) versus a mixed male/female treatment facility. Alcohol. Clin. Exp. Res. 1989; 13:499–504CrossRefGoogle ScholarPubMed
Gomberg, E. S.Women and alcohol: use and abuse. J. Nerv. Ment. Dis. 1993; 181:211–19CrossRefGoogle Scholar
Fleming, M. and Manwell, L. B.Brief intervention in primary care settings. Alcohol Res. Health 1999.; 23:128–37Google ScholarPubMed
Myrick, H., Brady, K. T. and Malcolm, R.New developments in the pharmacotherapy of alcohol dependence. Am. J. Addict. 2001; 10 (supp):3–15CrossRefGoogle ScholarPubMed
Schneider, K. M., Kviz, F. J., Isola, M. L. and Filstead, W. J.Evaluating multiple outcomes and gender differences in alcoholism treatment. Addict. Behav. 1995; 20:1–21CrossRefGoogle ScholarPubMed
Humphreys, K.Professional interventions that facilitate 12-step self-help group involvement. Alcohol Res. Health 1999.; 23:93–8Google ScholarPubMed
Longabaugh, R. and Morgenstern, J.Cognitive-behavioral coping-skills therapy for alcohol dependence. Alcohol Res. Health 1999.; 23:78–85Google ScholarPubMed
DiClemente, C. C., Bellino, L. E. and Neavins, T. M.Motivation for change and alcoholism treatment. Alcohol Res. Health 1999.; 23:86–92Google ScholarPubMed
Kranzler, H. R., Amin, H., Modesto-Lowe, V. and Oncken, C.Pharmacologic treatments for drug and alcohol dependence. Addict. Dis. 1999; 22:401–23Google ScholarPubMed
O'Malley, S. S.Opioid antagonists in the treatment of alcohol dependence: clinical efficacy and prevention of relapse. Alcohol Alcohol. Suppl. 1996; 1:77–81CrossRefGoogle Scholar
Anton, R. F., Moak, D. H., Waid, L. R., et al.Naltrexone and cognitive behavioral therapy for the treatment of outpatient alcoholics: results of a placebo-controlled trial. Am. J. Psychiatry 1999.; 156:1758–64Google ScholarPubMed
Kranzler, H., Tennen, H., Armeli, S., et al.Targetted naltrexone for early problem drinkers. Alcohol. Clin. Exp. Res. 2001; 25(supp):144AGoogle Scholar
Sass, H., Soyka, M. and Mann, K. and Zieglgansberger, W.Relapse prevention by acamprosate. Results from a placebo-controlled study on alcohol dependence. Arch. Gen. Psychiatry 1996.; 53:673–80CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×